Analyst - 340B Programs

Mercy Health BSMH • Richmond, VA

2d

About The Position

Everyone who works with Mercy Health is united under one purpose: to help our patients be well in mind, body and spirit. This drive, along with our history of faith, is a powerful combination. It gives us a shared calling to work toward every day. Join our exceptional team and help us continue to provide the highest quality of health care possible to our communities.
Primary Function/General Purpose of Position
The Senior Analyst position will primarily function to support the implementation of initiatives for Bon Secours Mercy Health 340B covered entity and contract pharmacy operations. Additionally, this position will deliver value through 340B program consulting or management engagements with external clients. Under the leadership of the Manager, 340B Programs, the Senior Analyst will serve as a 340B TPA implementation subject matter expert ensuring successful alignment of program compliance expectations and support software. They will also analyze and provide contract pharmacy claims reports to manufacturers and other third parties, review price contracting for 340B accounts, and support covered entities to ensure prompt replenishment of drugs to contract pharmacies pursuant to agreement terms and applicable delivery models. Functions related to 340B program consulting and program management services include program performance reporting & data analytics, configuration and maintenance of software systems, training of program support staff, project pro forma & annual program budgeting, program governance support & stakeholder education, HRSA audit support, 340B software and program services vendor RFP & contracting, and other projects as assigned by the Manager.
Essential Job Functions
Provides 340B TPA implementation support ensuring software configurations align with covered entity program compliance expectations.
Analyzes and compiles claims data extracts as required by manufacturers or other third parties to access 340B pricing through contract pharmacies.
Provides price contract analytics to confirm appropriate application across covered entity 340B accounts.
Supports covered entities by ensuring prompt replenishment of 340B drugs to contract pharmacies through applicable delivery models.
Supports the Manager through 340B consulting and program management service deliverables to external clients.
Provides compliance and financial performance reports for BSMH and external client Covered Entity programs through benchmarking dashboards and data analytic modeling.
Serves as the split billing software expert in order to troubleshoot software/data issues and continually improve software functionality.
Works with appropriate teams to ensure that the 340B software is coordinated and integrated with the clinical information system software. This shall include the electronic interface between the EMR and the virtual accumulator and any interface between BSMH and contract pharmacy providers and/or administrators.
Ensures integrity of split billing software and reviews applicable software reports to identify areas of improvement.
Triage live-site issues within the split billing software, electronic medical record, or charge master as it relates to 340B.
Collaborates with Epic charge team and charge master managers on a corrective action plan and participate in the implementation of any necessary changes.
Coordinates covered entity issue resolution process with split billing software vendor.
Ensures appropriate split billing software configurations are in place and continually update software to ensure alignment with revenue cycle/charging practices, Epic build, and Bon Secours Mercy Health Policies.
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Requirements

• 340B University Certificate (Live/On Demand) (required)
• Bachelors, Healthcare Administration/Business, Finance, Information Technology, Analytics, Pharmacy, Computer Science, Management Information Systems, or a related field (required)
• 2 years’ experience with pharmacy 340B (required)
• MS Office (Excel)
• Dashboard design
• Advanced knowledge of 340B Drug Pricing Program and/or healthcare billing regulations and practices
• Experience in Epic Electronic Health Record
• Auditing hospital charging/patient records
• Experience in 340B Split Billing/Third Party Administrator Software and/or manual 340B operations
• Excellent communication skills with ability to develop cross-departmental professional relationships
• Ability to begin 340B operations in new environment (including program operations design, setup of split billing software or manual tracker, staff education, policy and procedure development)
• Ability to work in a complex team environment and to collaborate with both external and internal professionals and other customers
• Excellent verbal and written communication skills; communication style that is open and fosters trust, credibility and understanding.
• Ability to ensure a high level of customer service for all customers including patients, local sites, local and home office employees, physicians and other medical professionals, visitors, and external stakeholders
• Computer skills – word processing, spreadsheets, PowerPoint®, drug databases
• Familiarity with various software, equipment and technology necessary to provide pharmacy services
• Knowledge of pharmacy services within acute and ambulatory care environments of an integrated health system and an ever-changing environment
• Knowledge of laws and regulations regarding pharmacy and external medication related quality metrics
• Ability to positively affect collaboration, promote teamwork and achieve consensus

Nice To Haves

• 340B Advanced Operations Certificate (preferred)
• 3 years’ experience in business, analytics, or auditing (preferred)
• Previous experience in managing HRSA 340B audits and corrective action plans
• Knowledge/training in Microsoft Access
• Experience in drafting Policies and Procedures
• Previous drug purchasing and/or wholesaler experience
• Experience in training employees, excellent communication skills, and experience leading large-scale software implementations. Strong interest in pharmacy practice advancement and pharmacy services leadership

Responsibilities

• Provides 340B TPA implementation support ensuring software configurations align with covered entity program compliance expectations.
• Analyzes and compiles claims data extracts as required by manufacturers or other third parties to access 340B pricing through contract pharmacies.
• Provides price contract analytics to confirm appropriate application across covered entity 340B accounts.
• Supports covered entities by ensuring prompt replenishment of 340B drugs to contract pharmacies through applicable delivery models.
• Supports the Manager through 340B consulting and program management service deliverables to external clients.
• Provides compliance and financial performance reports for BSMH and external client Covered Entity programs through benchmarking dashboards and data analytic modeling.
• Serves as the split billing software expert in order to troubleshoot software/data issues and continually improve software functionality.
• Works with appropriate teams to ensure that the 340B software is coordinated and integrated with the clinical information system software. This shall include the electronic interface between the EMR and the virtual accumulator and any interface between BSMH and contract pharmacy providers and/or administrators.
• Ensures integrity of split billing software and reviews applicable software reports to identify areas of improvement.
• Triage live-site issues within the split billing software, electronic medical record, or charge master as it relates to 340B.
• Collaborates with Epic charge team and charge master managers on a corrective action plan and participate in the implementation of any necessary changes.
• Coordinates covered entity issue resolution process with split billing software vendor.
• Ensures appropriate split billing software configurations are in place and continually update software to ensure alignment with revenue cycle/charging practices, Epic build, and Bon Secours Mercy Health Policies.

Benefits

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support
• Benefits may vary based on the market and employment status.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees